64-Multidetector Row CT Angiography (64-MDCTA) in Diagnosis of Intracranial Aneurysms in Acute Subarachnoid Hemorrhage: Comparative Study with Digital Subtraction Angiography (DSA),WAEL ABDULGHAFFAR and MONTASAR FOUDA
Abstract
Objective: The aim of this study was to compare 64- multidetector row CT angiography (64-MDCTA) with digital subtraction angiography (DSA) in diagnosis of intracranial aneurysms in cases of acute subarachnoid hemorrhage.
Materials and Methods: Our study included 50 patients 33 women and 17 men who undergone imaging on a 64- MDCT scanner (Light Speed VCT; GE Healthcare). The CTA was done using the following parameters; collimation 64 x 0.625mm; rotation time 0.350ms; pitch 0.531 in a caudocranial scan direction; tube voltage 120 kVp, tube current 350 mA, matrix of 512x512, field of view 18- 22cm, section thickness 1.25mm and reconstruction interval 0.625mm (50% overlap-ping). For post-processing, the reconstructed images were used to produce; Maximum intensity projection (MIP) refor-mats in axial, sagittal and coronal planes, 3-D Maximum intensity projection (MIP), and 3D volume rendered (VR) model. Digital subtraction angiography (DSA) was done in all cases.
Resuks: Out of 50 patients included in our study, 12 (24%) patients had negative study on CTA and DSA. A total 40 aneurysms had been identified on DSA (two patients had two aneurysms) in 38 patients and 38 aneurysms (95%) had been detected on CTA with two missed aneurysms on CTA (5%). Most of CTA-identified aneurysms (28 aneurysms=70%) were located within the anterior cerebral circulation and the remain-ing 10 aneurysms (25%) were located in posterior cerebral circulation. The sensitivity of MDCTA in detection of aneu-rysms in our study was 95%, the specificity was 100% and the total accuracy of about 96.2%.
Conclusion: 64-MDCTA is an accurate method in the diagnosis of intracranial aneurysms in acute spontaneous subarachnoid hemorrhage and can be used as an alternative method to DSA.